Chu Weihong, Wang Cheng, Wu Lijia, Lin Ping, Li Fang, Zou Runmei
Department of Pediatric Cardiovasology, Children's Medical Center, The Second Xiangya Hospital of Central South University/Institute of Pediatrics of Central South University, No. 139 Ren-min Middle Road, Changsha, 410011, Hunan, China.
Pediatr Cardiol. 2015 Apr;36(4):867-72. doi: 10.1007/s00246-015-1097-5. Epub 2015 Jan 11.
To explore whether oral rehydration salts (ORS) is effective in the treatment of children with vasovagal syncope (VVS). One hundred and sixty-six consecutive patients with recurrent syncope and positive head-up tilt testing (HUTT) were recruited, randomly divided to conventional therapy (health education and tilt training) plus ORS (with 500 ml of water) group (Group I, 87 patients) and conventional therapy group (Group II, 79 patients). Therapeutic effect was evaluated by changes of syncopal episode and reperformed HUTT response. At the end of 6-month follow-up, syncopal episode did not reoccur in 49 (56.3 %) patients, decreased in 34 (39.1 %) patients, and had no obvious change or increased in four (4.6 %) patients in Group I, and the results were 31 (39.2 %), 37 (46.8 %), and 11 (14 %) in Group II, respectively. The difference was significant (χ (2) = 7.074, P < 0.05). When HUTT was reperformed, 57 (65.5 %) and 28 (35.4 %) patients had negative response and 30 (34.5 %) and 51 (64.6 %) patients had positive response, respectively, in Group I and Group II. The difference was also significant (χ (2) = 13.808, P < 0.01). In Group I, the two aspects had no difference between vasodepressor type and mixed type; however, syncopal episode had a significant difference between children aged ≤12 and >12 years (χ (2) = 6.371, P < 0.05); there was no difference in reperformed HUTT response. ORS with 500 ml of water is an effective therapy for VVS. It can be recommended as one of non- pharmacological treatment measures in children with VVS.
探讨口服补液盐(ORS)治疗儿童血管迷走性晕厥(VVS)是否有效。招募了166例连续复发性晕厥且直立倾斜试验(HUTT)阳性的患者,随机分为常规治疗(健康教育和倾斜训练)加ORS(加500毫升水)组(Ⅰ组,87例患者)和常规治疗组(Ⅱ组,79例患者)。通过晕厥发作次数的变化和再次进行的HUTT反应评估治疗效果。在6个月随访结束时,Ⅰ组49例(56.3%)患者晕厥未再发作,34例(39.1%)患者晕厥发作次数减少,4例(4.6%)患者晕厥发作无明显变化或增加;Ⅱ组上述结果分别为31例(39.2%)、37例(46.8%)和11例(14%)。差异有统计学意义(χ² = 7.074,P < 0.05)。再次进行HUTT时,Ⅰ组57例(65.5%)患者反应阴性,28例(35.4%)患者反应阳性;Ⅱ组30例(34.5%)患者反应阴性,51例(64.6%)患者反应阳性。差异也有统计学意义(χ² = 13.808,P < 0.01)。在Ⅰ组中,血管抑制型和混合型在这两方面无差异;然而,≤12岁和>12岁儿童在晕厥发作次数上有显著差异(χ² = 6.371,P < 0.05);再次进行HUTT反应无差异。加500毫升水的ORS是治疗VVS的有效方法。可推荐作为儿童VVS的非药物治疗措施之一。